Library

Suwen: Mi Ci Lun states: If a person falls from a height, causing blood stasis to remain internally, resulting in abdominal fullness and distension, and inability to pass stool or urine, one should first administer purgative medicines. This refers to the injury of the Yin meridians above and the Luo-connecting vessels of Shaoyin below. One should puncture the area below the medial malleolus and anterior to the Ran Gu (KI 2) acupoint, allowing blood from the collateral vessels to flow. Then puncture the arterial pulse on the dorsum of the foot. If the condition does not improve, puncture each of the three hairs (San Mao, LR 1) on the big toe with one needle; bleeding immediately stops the condition. For left-sided symptoms, puncture the right side; for right-sided symptoms, puncture the left side.

The commentary in Yizong Jinjian notes: This describes the method of Mi Ci (mirrored needling) for diseases caused by blood stasis. Due to a fall, blood stasis remains internally, causing abdominal fullness and obstruction of the posterior orifice (anus). One should first use purgative medicines. If the upper part injures the Jueyin Liver meridian's main vessel, and the lower part injures the Shaoyin Kidney meridian's Luo-connecting vessel, one should puncture below the medial malleolus and anterior to Ran Gu (KI 2), inducing bleeding where collateral vessels are present, as this belongs to the branch Luo of Shaoyin which communicates with Jueyin. Simultaneously puncture the arterial pulse on the dorsum of the foot, which is Chong Yang (ST 42), the Yuan-source point of the Stomach meridian. If the illness persists, further puncture Da Dun (LR 1) at the San Mao (three hairs) area, one needle on each side; bleeding stops the condition immediately. The Mi Ci method involves puncturing the right Da Dun for left-sided symptoms, and the left Da Dun for right-sided symptoms. However, the arterial pulse on the dorsum of the foot involves the Chong, Shaoyin, and Yangming meridians; it should only be shallowly punctured, and excessive bleeding should be avoided.

Ling Shu: Han Re Bing Pian states: When the body suffers trauma with significant blood loss, or contracts wind-cold, or suffers a fall, leading to flaccidity and weakness of the four limbs that cannot be controlled, it is called "Ti Duo" (Body Languor). Treat the "San Jie Jiao" (Three Intersections) located three cun below the umbilicus. The "San Jie Jiao" refers to the intersection of the Yangming and Taiyin meridians, specifically Guan Yuan (CV 4), which is three cun below the umbilicus.

The commentary in Yizong Jinjian notes: This discusses cases of bodily trauma with excessive blood loss, or contraction of wind-cold, which belong to categories like Po Shang Feng (Broken Wind/lockjaw); or due to falls inevitably causing blood loss, resulting in flaccid and uncontrolled limbs, all termed "Ti Duo". Guan Yuan is an acupoint of the Ren (Conception) Vessel, and since both the Foot-Yangming and Foot-Taiyin meridians converge here, it is called the "San Jie Jiao".

Ling Shu: Jue Bing Lun states: Headache should not be treated by selecting distant acupoints if there has been a blow or fall, causing blood stasis internally. If the muscle pain from the injury has not yet healed, lateral needling near the site can be used; distant selection is not appropriate.

The commentary in Yizong Jinjian notes: The classic states that for internal blood stasis causing headache, one should not select specific acupoints to drain Qi. Generally, selecting acupoints for headache aims to drain Qi to relieve pain; however, if the cause is trauma with internal blood stasis, draining Qi treats the Qi rather than the Blood, so one should avoid selecting those distant acupoints. If the muscle pain from the blow or fall persists, even when using needling, one should only perform lateral needling near the injured area to expel the internal blood stasis; continuing to select distant acupoints along the meridians to treat the headache is incorrect.

Yaoshan comments: This elaborates on the principle of using Bian stones to remove blood stasis.

Yizong Jinjian states: If the Liver pulse is firm and hard while the complexion remains unchanged, there must have been a falling or striking incident. Since the skin/muscle is not broken, blood stasis likely remains under the ribs, accompanied by vomiting and reflux. According to the meridians, puncture Ran Gu (KI 2), the dorsal foot arteries, or San Mao (LR 1) to induce bleeding; or administer purgative medicines to move the blood stasis, and the condition should heal itself. If the pulse is floating, faint, and choppy, it indicates excessive blood loss. Moxibustion should be applied to the San Jie Jiao Guan Yuan (CV 4) point according to the meridians; or administer powerful Qi- and Blood-tonifying formulas to regulate the condition, and the illness will resolve.

Yaoshan comments: This is a general discussion on acupuncture, moxibustion, and herbal medicine, serving as the outline for diagnosing and treating such conditions. According to Ci Jiu Xin Fa Yao Jue, Jian Jing (GB 21) treats neck stiffness, elbow and arm pain with inability to lift, needled 5 fen, moxa 5 cones, contraindicated in pregnancy. Huan Tiao (GB 30) treats sprain-strain low back pain with inability to turn the head, needled 1 cun, retained for 10 breaths, moxa 3 cones. He Gu (LI 4) treats Po Shang Feng (Broken Wind), needled 3 fen, retained for 6 breaths, moxa 3 cones. There is also a paper-interposed moxibustion method, highly effective for severe pain from traumatic injuries, detailed below, which is an ancient warming therapy.

Jian Jing (GB 21) is an acupoint of the Foot-Shaoyang Gallbladder Meridian, located 1.5 cun anterior to the top of the shoulder bone, found in the depression centered between three fingers.

He Gu (LI 4) is the fourth acupoint of the Hand-Yangming Large Intestine Meridian, located in the depression between the metacarpal bones of the thumb and index finger, commonly known as the Tiger's Mouth.

Guan Yuan (CV 4) is an acupoint of the Ren (Conception) Vessel, located 3 cun below the umbilicus.

Huan Tiao (GB 30) is an acupoint of the Foot-Shaoyang Gallbladder Meridian, located in the hip joint pivot; take the point lying on the side with the lower leg extended and the upper leg flexed.

Chong Yang (ST 42) is an acupoint of the Foot-Yangming Stomach Meridian, located at the arterial pulse on the dorsum of the foot.

Ran Gu (KI 2) is an acupoint of the Foot-Shaoyin Kidney Meridian (Note: Text erroneously says Shaoyang, but context implies Kidney/Shao Yin as per standard anatomy and previous mention), located superior to Yong Quan (KI 1), in the depression anterior to the prominent bone of the medial malleolus.

Da Dun (LR 1) is the first acupoint of the Foot-Jueyin Liver Meridian, located on the lateral side of the big toe, at the San Mao (three hairs) area.

Zhen Jiu Da Cheng states: For sprain-strain causing spinal stiffness and waist/flank pain, select Ren Zhong (GV 26), needled 3 fen, retained for 6 breaths, moxa 3 cones; also select Wei Zhong (BL 40), needled 5 fen, retained for 7 breaths, moxa contraindicated. For pain from beating or falling, select Cheng Shan (BL 57), needled 7 fen, moxa 5 cones.

Ren Zhong (GV 26), also known as Shui Gou, is located in the central groove of the philtrum, below the nasal column, near the nostrils; it is the meeting point of the Du Vessel and the Hand-Foot Yangming meridians.

Wei Zhong (BL 40), also known as Xue Xi, is an acupoint of the Foot-Taiyang Bladder Meridian, located in the depression of the arterial pulse at the center of the popliteal crease. Have the patient lie prone with face down to locate the point.

Cheng Shan (BL 57), also known as Yu Fu, Rou Zhu, or Chang Shan, belongs to the Foot-Taiyang Meridian. It is located in the fleshy separation between the muscles of the calf. To locate it, support oneself high against a wall with both hands, lift heels off the ground, raise the big toes, and look up towards the fleshy separation below the sharp bone of the heel.

Lei Huo Zhen (Thunder Fire Needle) method treats pain in bones and joints from sprains and strains, as well as cold-dampness, suitable for those afraid of needling. Use Chen Xiang (Aquilaria Wood), Mu Xiang (Aucklandia Root), Ru Xiang (Frankincense), Yin Chen (Artemisia Capillaris), Qiang Huo (Notopterygium Rhizome), Jiang (Ginger), Chuan Shan Jia (Pangolin Scales) each 3 qian, She Xiang (Musk) a small amount, and Qi Ai (Artemisia Mugwort) 2 liang. Use half a chi of cotton paper, first lay mugwort on top, then sprinkle the powdered herbs, roll tightly, and store. Press against the painful acupoint, mark with a pen, cover with 6-7 layers of paper, ignite the rolled herb-mugwort mixture, named Lei Huo Zhen. Utilize true solar fire or a convex lens to ignite until red-hot, press onto the acupoint for a while, remove, trim ash, re-ignite and press again; nine cycles constitute a cure.

Shan Die Jiu Yao (Flash/Fall Moxibustion Medicine): Specifically treats traumatic injuries and rheumatic pain. Liu Huang (Sulfur) 2 liang, Yin Zhu (Cinnabar mixed with sulfur?), Ming Xiong Huang (Realgar), Chen Sha (Cinnabar) each 3 qian, Chuan Wu (Aconitum carmichaelii), [Caowu implied] each 1.5 qian, Sheng Da Huang (Raw Rhubarb), Huang Bo (Phellodendron Bark) each 1 qian, She Xiang (Musk) 1 fen. First melt the Sulfur, mix in the other powdered herbs evenly. Pre-lay a large sheet of paper on the ground, pour the medicine onto it, cover with another sheet of paper, and press flat into blocks. After cooling, each square inch of paper can be cut into ten blocks. Ignite one block, place it on thick coarse paper, and continuously move the thick paper to iron/warm the area. Replace the medicine when exhausted, continuing until heat penetrates to the muscles and bones, causing immediate circulation of Qi and Blood, and the ailment disappears.